NHS Clinical Commissioners has argued that out-of-hours GP care needs to be improved and clinical commissioning groups are best placed to drive developments.
NHS CC, the independent collective voice for Clinical Commissioning Groups established by the NAPC, the NHS Alliance and the NHS Confederation, made their comments following a speech by Health Secretary Jeremy Hunt, who blamed GPs for the rise in A&E admissions.
In the speech at an Age UK conference, Hunt said, “When I have been visiting A&Es in recent weeks, hard-working staff talk about the same issues: lack of beds to admit people, poor out-of-hours GP services, inaccessible primary care and a lack of coordination across the health system.
“The decline in out-of-hours care follows the last government’s disastrous changes to the GP contract, since when we have seen four million more people using A&E every year. We must address these system failures, and I am determined we will.”
The last government changed the GP contract so that GPs could opt out of proving out-of-hours care, resulting, many say, in a decline in the standard of the provision of care.
Hunt’s comments have been fiercely criticised by doctors’ leaders.
Dr Clare Gerada, Chair of the RCGP called his assessment of the situation as “unacceptable” and inaccurate.
Dr Mark Porter, Chair of BMA Council, said, “Singling out individual parts of the health service and engaging in a blame game is unhelpful and misses the point.
“Ministers should be engaging positively with healthcare professionals to improve and maintain services for patients, rather than demoralising NHS staff who are working harder than ever with fewer resources, wherever they are in the service.”
NHS CC has now joined the debate, arguing that it is a statutory duty of CCGs to ensure the provision of that care.
Dr Steve Kell and Dr Amanda Doyle Co-Chairs of NHS Clinical Commissioners Leadership Group have said, “It is quite clear that Out of Hours care needs to be improved.
“Professor Steve Field is absolutely right when he says that finding a solution must involve GPs and we would take that one step further and say that what it needs is the direct involvement of local commissioners to find that solution.”
They added that the recent issues with NHS 111 “clearly show” that CCGs are “best placed to work within their areas to develop appropriate solutions by specifying and commissioning high quality services”.
The continued, “In the very great majority of areas, where GPs have opted out of providing an Out of Hours service, CCGs have a statutory duty to ensure the provision of that care. CCGs are responsible for commissioning all parts of the scheduled care mix so they are uniquely placed to ensure that a coordinated system is put in place.
“Moreover A&E is just one part of the urgent care system, and it is important we address primary, secondary and community service issues and capacity when improving care for patients.
''Our view is that CCGs should review current Out of Hours provision to ensure it is safe and effective, and by harnessing their clinical values ensure they are getting the specification right and commissioning a co-ordinated service which delivers value for their populations. ”
By Kirsty Hough